MSK Reform #3 Reforming Clinical Education

This is the third article in a series looking at the proposals of MSK Reform from an osteopathic perspective. The education work I do is as a visiting post-graduate lecturer so my insights on this section are limited. I’d be pleased to hear the thoughts of any with more insight into the application of these proposals in an osteopathic context.

MSKR propose a clinical education online learning resource to support clinical educators offering MSK placements. 

In osteopathy not all clinical educators have teaching qualifications and some may not be applying what is considered best practice. Confusing messages from different members of faculty could be a potential issue for students. Many clinical supervisors work from a predominantly biomedical model. 

The best MSK clinical educators according to student physios are: 

  • Not the most competent or experienced 
  • Comfortable with unknowns and admit it 
  • Person-centred BPS 
  • Comfortable discussing and using current evidence to guide decisions 
  • Encourage questioning 
  • Engage in critical discussions, be flexible/understanding of different approaches 

I would suggest these sentiments would be supported by osteopaths too. 

Clinical educator training could potentially raise standards and is to be encouraged. 

There are efforts being made to encourage the osteopathy colleges to work together in raising the standards of clinical educators. 

CLINICAL EDUCATION QUANTITY 

MSKR propose a promotional campaign which highlights the positive impact of student placements on productivity of MSK services 

MSKR advocate a universal code of conduct detailing the responsibilities of HEIs, clinical educators, students and service providers before, during and after student placement 

The placement model MSK reforms proposed are not necessarily relevant to osteopathy. However, it may stimulate some thought as to whether the model of clinics that colleges have does provide a broad clinical experience. Are there ways that more diversity of clinical experience could be provided particularly with increasing opportunities for osteopaths to work in sports, occupational health, first contact roles. How could your student clinical experience have been enhanced? 

THE GRADUATE SKILL GAP 

MSKR propose a formal, universal preceptorship pathway for graduates aspiring to MSK Excellence. 

If, like me, you are wondering what is the difference between a preceptor and a mentor this is what google said: 

Preceptors are teachers or tutors while a mentor is a trusted counsellor or guide. 

The Osteopathic Development Group has been training osteopaths to be mentors, particularly for new graduates. Is there scope for expanding this and adopting a preceptorship model? Osteopaths of all levels of experience may benefit from a mentoring relationship.  

MSKR proposes a preceptorship programme run by universities adding value to their courses by extending support beyond graduation. They suggest making available 2 years of preceptorship within the first 4 years of graduation. An interesting concept which could be applied in osteopathy. I am sure that this is something I would have utilised as a new graduate launched into private practice. 

MSKR propose a process for MSK professionals who have been long graduated to complete the credentialing element and engage with the mentoring component of the preceptorship programme detailed in the previous policy. 

Recognising the changes taking place in MSK knowledge and understanding it is proposed that clinical excellence could be achieved through a recognised process. The Institute of Osteopathy is given as an example but I am not sure what they are referring to. The Musculoskeletal Association of Chartered Physiotherapists is a second pathway which has particular pathways for membership.  

A universal mark of MSK competence is proposed. This is an interesting concept which has been used in several different disciplines such as Investors in People and other industry marks. It would need a significant educational campaign to make patients aware of the meaning of the mark otherwise it may just be an inter-professional recognition. 

Conclusion

There are some interesting concepts in this education section. It’s very easy to dismiss it as just being for the educational establishments and new graduates. I think it is important that all osteopaths think about what would improve the quality of graduates and enhance ongoing practice. We have all been through education and getting established in practice – what would have benefitted you? Do you think any of these proposals would have improved your experience or would help you now? 

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